The next
time you think about going down on a woman, think about this: She is almost
certain to have been infected at some point with a virus that could, years from
now, give you throat cancer.
The most
common sexually transmitted disease in the U.S., human papillomavirus, or HPV, has been blamed for a
recent, rapid increase in the incidence of throat cancer – a disease that used
to be rare in people who didn't drink or smoke excessively. According to data
from 2004, the most recent available, rates of HPV-related throat cancer had risen 225
percent in the previous 16 years, with men suffering the most cases.
Researchers point to the increasing popularity of oral sex – often seen as
safer than intercourse – among heterosexual couples, a trend that may soon lead
to more male fatalities in industrialized nations from HPV-related infections
than female ones – a surprising turnaround after decades when women suffered
higher death rates from the virus, which also causes cervical cancer through
vaginal sex.
Most
people who contract HPV get rid of the virus within a few years without side
effects or complications, and the number of men infected with HPV who actually
develop cancer is still very small. The bad news, however, is that researchers
believe there is virtually nothing a heterosexual man with a normal sex life
can do to avoid HPV infection. Virgins who have done nothing but open-mouthed
kissing have been found to be infected. One study even discovered that kissing may increase your risk of oral infection more than having
intercourse. How about monogamy? Sorry, but that one's out,
too. A study of coeds at the University of Washington found that
half of women who had had only one sexual partner were infected with the virus
after three years of partnership. Even fooling around can be risky, since skin under
the fingernails can contain the virus. Condoms are helpful, but HPV
can attach to so many different surfaces that even they are not foolproof.
A large
part of the problem is HPV's universality. The Centers for Disease Control and Prevention approximates that
80 percent of women in the U.S. have been exposed to the virus by age 50, an
estimate that some researchers think is low. No one is quite sure what the
exposure rate among men is, although guys tend to become infected more readily
than women: Studies of college students found active infections in half of
women and nearly two-thirds of men. "If you're sexually active,
in all probability, you have already been exposed," said Dr. Maura L. Gillison, a professor of medicine at Ohio State University's
comprehensive cancer center.
While there
are more than 100
strains of the HPV virus, most oral cancers result from HPV-16.
Those who test positive for HPV-16 are 14 times as likely to develop oral
cancer as those who do not. (There are at least seven other strains
known to cause cancers, including cervical, anal, penile, and vulvar, as well
as six more suspected of doing so.)
Unlike
cervical cancer, which can be detected with a Pap smear,
there is no test that can easily identify HPV-related throat cancer. By the
time those with the disease become aware that they're sick, cancer has often
spread to their lymph nodes. Surgery can be disfiguring, and chemotherapy and
radiation are exhausting and debilitating. And while HPV-related throat cancers
are generally more curable than those that result from smoking or alcohol use, 40 percent of
the 36,000 people diagnosed each year with oral cancer will die from
the disease within five years. Between 1992 and 2001 – in the most recent data
available – oral cancer ranked as the seventh most common cancer among men in
the U.S.
In 2007,
Kevin McConnell, 51, of Annapolis, Maryland, developed what he thought was a
terrible earache. After the pain spread to his neck and tongue, he saw a doctor
who referred him to a specialist. Although the specialist found no evidence of
cancer, he sent him for two brain scans, both of which were negative. Three
weeks later, McConnell developed a lesion on his tongue that spurred him to see
an expert at Johns Hopkins,
who told him he had a 3.5-centimeter tumor that was cancerous and
life-threatening. After seven weeks of intensive radiation and treatments,
McConnell has recovered and is in remission, but he says he gets mixed
reactions when he tells women he dates that he had oral cancer as a result of
an HPV infection. "I've had some people freak out about it and say they
don't want to date me," he says, pointing out – accurately – that most of
these women have probably already had the virus themselves.
Although
there's little you can do to decrease the possibility of contracting HPV,
researchers have identified risk factors. Losing your virginity at an early age
and having many sexual partners boost your chances; so do tobacco use and a
history of genital warts. But many mysteries remain, including why men who use
marijuana seem to be at greater risk for HPV-related oral cancers and what role
race might play. A 2009 study, for example, found that white men are almost
nine times as likely as black men to suffer HPV-related oral cancers. Whether
this disparity is owing to a difference in sexual behavior is unknown.
SOURCE: MEN'S JOURNAL
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